Skip to main content
SpringerLink
Log in

Treatment option for arachnoid cysts

  • Original Paper
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Objective

The objective of this study is to establish which treatment is the best operative intervention for arachnoid cyst.

Materials and methods

We reviewed a series of 209 cases with arachnoid cysts focusing on the effectiveness and safety. The cysts were treated with several surgical procedures including open surgery for fenestration, endoscopic fenestration, or cystoperitoneal shunting.

Results

Follow-up imaging studies showed that 176 out of 209 arachnoid cysts (84.2%) reduced in size during a mean postoperative follow-up period of 6.9 years (range, 1 to 14 years). Although a cystoperitoneal shunt was the best method for early achieving an obliteration of the sylvian cyst (89%), it had the danger of shunt dependency (42%) in addition to four early complications. Although endoscopic fenestration tended to be less effective in reducing the size of a sylvian cyst, it was safe and particularly effective in completely obliterating a suprasellar, quadrigeminal, and prepontine cyst.

Conclusion

Although the shunt for arachnoid cyst can get the more rapid good radiological outcome, the shunt-related complication and dependency would be hazardous. We suggest that endoscopic or reduced open procedures offer the advantage of avoiding a large craniotomy or the known complications of a cystoperitoneal shunt in treatment of arachnoid cysts. We could get the nearly same surgical outcome without shunt complications with endoscopic or open procedures.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Aoki N, Sakai T (1990) Intraoperative subdural hematoma in a patient with arachnoid cyst in the middle cranial fossa. Childs Nerv Syst 6:44–46

    Article  PubMed  CAS  Google Scholar 

  2. Aoki N, Sakai T, Umezawa Y (1990) Slit ventricle syndrome after cyst-peritoneal shunting for the treatment of intracranial arachnoid cyst. Childs Nerv Syst 6:41–43

    Article  PubMed  CAS  Google Scholar 

  3. Caemaert J, Abdullah J, Calliauw L, Carton D, Dhooge C, van Coster R (1992) Endoscopic treatment of suprasellar arachnoid cysts. Acta Neurochir (Wien) 119:68–73

    Article  CAS  Google Scholar 

  4. Charalampaki P, Filippi R, Welschehold S, Conrad J (2005) Endoscopic and endoscope-assisted neurosurgical treatment of suprasellar arachnoidal cysts (Mickey Mouse cysts). Minim Invasive Neurosurg 48:283–288

    Article  PubMed  CAS  Google Scholar 

  5. Choi JU, Kim DS, Huh R (1999) Endoscopic approach to arachnoid cyst. Childs Nerv Syst 15:285–291

    Article  PubMed  CAS  Google Scholar 

  6. Choux M, Raybaud C, Pinsard N, Hassoun J, Gambarelli D (1978) Intracranial supratentorial cysts in children excluding tumor and parasitic cysts. Childs Brain 4:15–32

    PubMed  CAS  Google Scholar 

  7. Ciricillo SF, Cogen PH, Harsh GR, Edwards MS (1991) Intracranial arachnoid cysts in children. A comparison of the effects of fenestration and shunting. J Neurosurg 74:230–235

    Article  PubMed  CAS  Google Scholar 

  8. Dei-Anang K, Voth D (1989) Cerebral arachnoid cyst: a lesion of the child’s brain. Neurosurg Rev 12:59–62

    Article  PubMed  CAS  Google Scholar 

  9. Ersahin Y, Kesikci H, Ruksen M, Aydin C, Mutluer S (2008) Endoscopic treatment of suprasellar arachnoid cysts. Childs Nerv Syst 24:1013–1020

    Article  PubMed  Google Scholar 

  10. Galassi E, Piazza G, Gaist G, Frank F (1980) Arachnoid cysts of the middle cranial fossa: a clinical and radiological study of 25 cases treated surgically. Surg Neurol 14:211–219

    PubMed  CAS  Google Scholar 

  11. Galassi E, Gaist G, Giuliani G, Pozzati E (1988) Arachnoid cysts of the middle cranial fossa: experience with 77 cases treated surgically. Acta Neurochir Suppl (Wien) 42:201–204

    CAS  Google Scholar 

  12. Gangemi M, Colella G, Magro F, Maiuri F (2007) Suprasellar arachnoid cysts: endoscopy versus microsurgical cyst excision and shunting. Br J Neurosurg 21:276–280

    Article  PubMed  CAS  Google Scholar 

  13. Geissinger JD, Kohler WC, Robinson BW, Davis FM (1978) Arachnoid cysts of the middle cranial fossa: surgical considerations. Surg Neurol 10:27–33

    PubMed  CAS  Google Scholar 

  14. Hagebeuk EE, Kloet A, Grotenhuis JA, Peeters EA (2005) Bobble-head doll syndrome successfully treated with an endoscopic ventriculocystocisternostomy. Case report and review of the literature. J Neurosurg 103:253–259

    PubMed  Google Scholar 

  15. Hanieh A, Simpson DA, North JB (1988) Arachnoid cysts: a critical review of 41 cases. Childs Nerv Syst 4:92–96

    PubMed  CAS  Google Scholar 

  16. Harsh GR IV, Edwards MS, Wilson CB (1986) Intracranial arachnoid cysts in children. J Neurosurg 64:835–842

    Article  PubMed  Google Scholar 

  17. Kim DS, Choi JU, Huh R, Yun PH, Kim DI (1999) Quantitative assessment of cerebrospinal fluid hydrodynamics using a phase-contrast cine MR image in hydrocephalus. Childs Nerv Syst 15:461–467

    Article  PubMed  CAS  Google Scholar 

  18. LaCour F, Trevor R, Carey M (1978) Arachnoid cyst and associated subdural hematoma. Observations on conventional roentgenographic and computerized tomographic diagnosis. Arch Neurol 35:84–89

    PubMed  CAS  Google Scholar 

  19. Okumura Y, Sakaki T, Hirabayashi H (1995) Middle cranial fossa arachnoid cyst developing in infancy. Case report. J Neurosurg 82:1075–1077

    Article  PubMed  CAS  Google Scholar 

  20. Pei A, Zhang YZ, Zong XY, Wang XS, Song M (2007) Endoscopic treatment of suprasellar arachnoid cysts. Zhonghua Yi Xue Za Zhi 87:311–314

    PubMed  Google Scholar 

  21. Rappaport ZH (1993) Suprasellar arachnoid cysts: options in operative management. Acta Neurochir (Wien) 122:71–75

    Article  CAS  Google Scholar 

  22. Santamarta D, Aguas J, Ferrer E (1995) The natural history of arachnoid cysts: endoscopic and cine-mode MRI evidence of a slit-valve mechanism. Minim Invasive Neurosurg 38:133–137

    Article  PubMed  CAS  Google Scholar 

  23. Schroeder HW, Gaab MR (1997) Endoscopic observation of a slit-valve mechanism in a suprasellar prepontine arachnoid cyst: case report. Neurosurgery 40:198–200

    Article  PubMed  CAS  Google Scholar 

  24. Schroeder HW, Gaab MR, Niendorf WR (1996) Neuroendoscopic approach to arachnoid cysts. J Neurosurg 85:293–298

    Article  PubMed  CAS  Google Scholar 

  25. Sprung C, Mauersberger W (1979) Value of computed tomography for the diagnosis of arachnoid cysts and assessment of surgical treatment. Acta Neurochir Suppl (Wien) 28:619–626

    CAS  Google Scholar 

  26. Stein SC (1981) Intracranial developmental cysts in children: treatment by cystoperitoneal shunting. Neurosurgery 8:647–650

    Article  PubMed  CAS  Google Scholar 

  27. Tamburrini G, Dal Fabbro M, Di Rocco C (2008) Sylvian fissure arachnoid cysts: a survey on their diagnostic workout and practical management. Childs Nerv Syst 24:593–604

    Article  PubMed  Google Scholar 

  28. Wang JC, Heier L, Souweidane MM (2004) Advances in the endoscopic management of suprasellar arachnoid cysts in children. J Neurosurg 100:418–426

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Pediatric Neurosurgery, Severance Children’s Hospital, Brain Korea 21 Project for Medical Science, Department of Neurosurgery, Brain Research Institute, Yonsei University College of Medicine, C. P. O. Box 8044, Seoul, South Korea

    Kyu-Won Shim, Yoon-Ho Lee, Eun-Kyung Park, Young-Seok Park & Dong-Seok Kim

  2. Pochon CHA University College of Medicine, Seongnam, South Korea

    Joong-Uhn Choi

Authors
  1. Kyu-Won Shim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yoon-Ho Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Eun-Kyung Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Young-Seok Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Joong-Uhn Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Dong-Seok Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dong-Seok Kim.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shim, KW., Lee, YH., Park, EK. et al. Treatment option for arachnoid cysts. Childs Nerv Syst 25, 1459–1466 (2009). https://doi.org/10.1007/s00381-009-0930-7

Download citation

  • Received:

  • Revised:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-009-0930-7

Keywords

Search

Navigation